Atherogenic index of plasma predicts cerebrovascular accident occurrence in antineutrophil cytoplasmic antibody-associated vasculitis

Abstract

Background: To investigate whether atherogenic index of plasma (AIP) at diagnosis is associated with the occurrence of cerebrovascular accident (CVA) or coronary artery disease (CAD) in antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Methods: The medical records of 167 AAV patients on initial diagnosis was reviewed, and 300 healthy controls were included. AIP was calculated using the following equation: AIP = Log (triglyceride [mg/dL] / high-density lipoprotein cholesterol [mg/dL]). AAV patients were divided into two groups according to the AIP cutoff of 0.11. The event of stroke, transient ischemic attack, and cerebral hemorrhage was recorded as CVA, and CAD events consisted of either myocardial infarction and angina pectoris. CVA-and CAD-free survival rate between those with AIP ≥ 0.11 and < 0.11 were compared by the Kaplan-Meier analysis, and Cox hazard analysis was conducted to identify predictors of CVA. Results: The median age of AAV patients were 59.0 years, and 54 (32.3%) patients were male. One-hundred and fifteen (68.9%) patients had AIP < 0.11 and 52 (31.1%) had AIP ≥ 0.11. The mean Birmingham vasculitis activity score in AAV patients with AIP < 0.11 was lower than that seen in patients with AIP ≥ 0.11 (12.0 vs. 14.0, P = 0.041). AAV patients had a significantly higher AIP compared to controls (mean − 0.01 vs.-0.10, P < 0.001). During follow-up, the occurrence of CVA and CAD was observed in 16 (9.6%) and 14 (8.4%) patients, respectively. In Kaplan-Meier analysis, AAV patients with AIP ≥ 0.11 had significantly lower CVA-free survival rates than in those with AIP < 0.11 (P = 0.027), whereas there was no difference in CAD according to AIP (P = 0.390). Multivariable Cox analysis indicated that AIP ≥ 0.11 at diagnosis was the sole predictor of CVA (Hazard ratio 3.392, 95% confidence interval 1.076, 10.696, P = 0.037).

Association of Lipid Ratios and Neutrophil-lymphocyte Ratio in Type 2 Diabetic Moroccan Patients Without Chronic Kidney Disease

“…Hypertriglyceridemiae was the major lipid parameter disorder in this study in both groups with good and poor controlled diabetes [27.9% vs 33.1%), this finding is consistent with previous studies in Ethiopia (63.5%) [24] and Sudan (48.8%) [25]. In the literature, abnormal lipid metabolism in diabetic patients is often manifested by elevated TG, and reduced HDL levels [26,27], therefore, these abnormalities are not always revealed by conventional lipid measures, as LDL-c levels may remain within the normal range [28,29]. It may be better revealed by the lipid ratios; our data revealed high median levels of AIP (0.06 vs -0.02), non-HDL-c (1.27 g/L vs 1.23) and TC/ HDL-c (9.36 vs 8.7) in the poor controlled group compared to the controlled diabetes groups, but the difference was not statistically significant (P>0.05).…”

Genetic Determinants of Atherogenic Indexes

“…The AIP and CI2 indexes have emerged as surrogate markers of cardiovascular health as they have been reliably correlated with cardiovascular risk, lipoprotein size [17,29], or plasma atherogenicity [30]. They have demonstrated to be better CVD predictors compared to TG/HDL-C alone [31,32]. M. Dobiasova and J. Frohlich showed that the AIP index closely correlates to lipoprotein particle size and fractional esterification rate of HDL-C which in turn is a predictor of coronary artery disease risk [33,34], cerebrovascular accident [35], the thickness of the carotid intima-media, statin response, and ischemic stroke [36].…”

Triglyceride-Rich Lipoproteins and Their Remnants as Silent Promoters of Atherosclerotic Cardiovascular Disease and Other Metabolic Disorders: A Review

“…In the Kaplan Meyer analysis, it has been shown that AAV patients with an atherogenic index higher than 0.11 presented a significantly reduced rate of cerebrovascular accident–free survival when compared to those with an atherogenic index <0.11 ( p = 0.027). Of note, higher atherogenic index values were recorded in the AAV group than in the control group ( p < 0.001) [ 51 ].…”